Perhaps one of the most important decisions you can make regarding your future is whether or not you wish to have certain medical treatments administered in the event of your physical or mental incapacity. You may already understand the importance of documenting these wishes - and you are probably already aware that you can select the individual of your choice to make your medical and financial decisions on your behalf in the event that you cannot. However, despite your well thought-out plans, these advance medical directives may not always be valid. And the result could be an emotional and financial disaster for your surviving family.

Consider the story of Laura, married to Jim, with two teenage daughters. As an ICU nurse, Laura had seen more than her share of patients kept alive by artificial means and did not want to end up in a similar situation. Therefore, she made sure that she and Jim had living wills included in their estate plans. Laura was firm with her decision and shared it with her family members.

Eight years after the documents were signed in their home state, Laura and Jim were on their annual vacation at their out-of-state cabin near her parents' house. While hiking in the mountains, Laura slipped and tumbled into a ravine. She suffered a back injury and was unconscious when airlifted to the hospital. Laura was paralyzed from the neck down, never woke up, and was kept on a ventilator system. Jim and her parents stayed by her side. After six weeks, Jim presented Laura's living will with instructions to let her die. Her parents objected for religious reasons and took the case to court. The judge ruled in their favor.

The court took the position that if Laura had wanted a binding document, she would have drafted one in the state where she owned a second home. Additionally, the judge pointed out that since the living will from Laura's home state had not been updated for several years, it might not express her current wishes.

Ten years after the accident, Laura is still on the ventilator. Her parents and Jim have been fighting an ongoing legal battle that has cost both sides hundreds of thousands of dollars. As for Laura's children, they occasionally visit her but can only watch and suffer.

Advance directives are used throughout the country, but there are no universal forms and individual state law governs these documents. While some states will recognize the laws of the state where the directive was issued, others may not since the rules may vary from state to state. And the titles of the documents may differ as well.

Complications can also result when states:

Require that you use their statutory forms

Are very specific about which types of advance directives their laws will recognize

Require that certain conditions be met before your instructions are honored

Will not recognize documents that do not include the signature of the person who is to make decisions for you

Furthermore, there are some states that take the position that once certain treatments have begun, they cannot be stopped by an advance directive. And a number of states' laws make it better to combine a power of attorney with a living will into one document, while several do not.

There are a few steps you can take to assure that your wishes are followed from state to state.

Review your current documents with your attorney

Execute separate documents for each state where you frequently spend time

Name the same person as your representative in every state's documents

You may also want to schedule an annual review with your attorney because states' laws occasionally change. In addition, new case law provides new precedents, thus possibly making forms you have used obsolete.

Once you have implemented these tasks, there is one more thing that you can do: Ask every family member over the age of 18 do the same. Although no one can predict what their future may hold, proper planning can provide protection from emotional and financial disaster for you and your loved ones.

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